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07/12/94 09:31 FAX 812 426 5790 <br />McNAMARA COMPANY <br />MINNESOTA JOINT UNDERWRITING ASSOCIATION <br />PIONEER 'P.O. BOX 1760 <br />ST. PAUL, MN 55101 222 -0484 <br />1- 800- 552 -0015 OR <br />APPLICATION FOR LIQUOR LIABILITY COVERAGE <br />Coverage will not be bound if the correct premium payment, written <br />rejection, current license and'required documentation of liquor <br />receipts are net attached. Coverage eraa no be <br />eobo by prior to <br />12:01 a.m. the day following receipt c t <br />Administrator. <br />Legal Name of Applicant Little Canada Canadian Days, Inc. <br />Trade Name Canadian Days <br />Mailing Address 515 East Little Canada Road, Little Canada, MN 55117 <br />_Individual _ Partnership X corporation X Non - Profit Other <br />If Applicant is Individual: <br />Applicant Name Julie Manville Spouse Name <br />If Applicant is a Partnership of Corporation: of Ownership <br />Name of Each Partner or Owner <br />10002 <br />Operating Locations) - List all Locations: <br />1. 515 East Little Canada Road, Little Canada Spooner Park, Eli Road, Little Canada <br />Classification Organized to plan and oversee city's annual celebration <br />Primary Nature of Business: <br />Check all applicable. <br />1. Restaurant' 2. Club <br />4. Bowling alley 5. r0n /Off Sales <br />6 . O f f Sale Only 7 . x Special Event <br />Total Gross Receipts of Entire Establishment <br />3. Bar <br />$15,880 <br />Gross Receipts from Liquor Sales Included Above $2,427 <br />Seating Capacity. Total <br />License in Effect? Yes X No <br />Licensing Authority ThiIE of Linn Canada <br />Address 515 Eat Little Canada Road, Littl$ Canada, MN 55117 <br />License Number Expiration Date <br />Effective Date yes, date IE No License Ever Revoked /Suspended? Yes X Y <br />If yes, explain <br />Bar Only <br />Page 15 <br />